Video conference request form
In order to have a successful video conference here are some guide lines

Your responsibility:

  1. Ensure that the video conference is relevant to your curriculum
  2. Allow a Minimum of two weeks between request and actual video conference
  3. Verify your network has 100mb capability. (your building tech can help you with this).
  4. Ensure you have a network jack in the space you are planning to use.
  5. Students will need to have a Media Permissions form on file,
  6. Complete this form
  7. Coordinate content of video conference with distant site.
  8. Coordinate public relations around video conference.

Educational Technologies responsibility

  1. Do a site visit to ensure the space is OK for video conferencing, gather jack and switch information if it has not been provided.
  2. Provide the equipment needed on the test day and the day of the event.
  3. Provide internal and external IP mapping for your site.
  4. Coordinate technical aspects of testing with the distant site.
  5. Provide the technical support on day of video conference

Additional info
  • This is the information that might be asked from a video conferencing partner
  • We use a Polycom VSX7000
  • We can provide them a public IP address but we also need to know what their IP address is. We prefer to call them.
  • We are located in the Central Time Zone of the United States.(CST)
  • We connect using IP calling over the public Internet
  • Our preferred calling speed is 384  Mbps
  • We can not do ISDN video conference calls.
Your Contact Info:
Your Name 
Your email 
Your Building 
Room used for video conference 
Ethernet Jack Number 
Please provide us the number that corresponds to the Ethernet jack we will be using for this video conference.

Information about the distant site(The party you will be video conferencing with)
Distant Site Name 
Technical Contact 
Tech Contact email 
Site Phone  
Distant site Time Zone 
Distant Site IP address 

Dates for the video conference
Video Conference Date
Please keep in mind we need a two week notice for all video conferences
Other Dates 
Date for testing
We will need to test at least two days before the actual video conference
Is This A Skype Conference
Do You Need On-Site Tech Support